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Cholesterol

Cholesterol: Free advice – ask me today!

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By Dr Helen Webberley MBChB MRCGP MFSRH | GMC no. 3657058

I am a GP and a sexual health and hormone specialist. I can give advice on any medical matter, and I offer safe access to medical advice, prescription medication, blood tests and x-rays, and specialist referrals to your local private hospital as needed.

Cholesterol – angel or daemon?

 

Cholesterol is a fat molecule manufactured in the liver and also found in some foods (mostly animal fats). It is an important structural component of cell membranes, an essential precursor of Vitamin D, certain hormones (particularly sex hormones) and bile acids.

Even though cholesterol is essential to the normal function of the body, too much can cause harm to your heart and  circulatory system, through atherosclerosis (deposits of cholesterol in your blood vessels), a condition that if ignored, can lead to fatal consequences.

Frequently Asked Questions

Is there really a good and a bad cholesterol?
Yes, cholesterol comes in a good and a bad form. One which protects you and one which can harm you. If you have ever had cholesterol blood tests before, you may have heard of LDL, HDL and triglycerides. These acronyms come from the names of proteins that carry cholesterol through the blood, lipoproteins.

There are five major groups of lipoproteins, ordered by density, from least dense to most dense. But only two of them are needed to assess the risk of cardiovascular disease: Low Density Lipoprotein (LDL) – the bad cholesterol – and High Density Lipoprotein (HDL) – the good one.

What about triglycerides?
Like cholesterol, triglycerides are also a form of fat found in food or produced by the liver, and their main purpose is to store energy. If you eat more calories than you burn, you may have a high level of triglycerides in the blood and it goes hand in hand with low HDL levels.
Raised triglycerides are an independent risk factor for heart disease and diabetes.

What are the causes of high cholesterol?
  • Heredity
  • Diet and lifestyle
  • Weight
  • Sex, age and ethnicity
  • Medical history
Which foods are bad for my cholesterol levels?
    • Full dairy cream
    • Animal fats – butter, margarines, ghee, lard, dripping, suet
    • Fatty meat
    • Processed meat products
    • Coconut and palm oils
Which foods are good to lower LDL cholesterol and raise HDL?
    • Soya foods
    • Nuts, seeds, whole grains
    • Oats and barley
    • Lots of fruits and vegetables
Do I have to avoid every food that is rich in cholesterol?

You don’t have to restrict foods low in saturated fat but rich in cholesterol like lean meat, liver, prawns, lobster or egg yolk. You do need cholesterol in your diet after all.

Is diet enough to keep bad cholesterol at bay?
A healthy lifestyle is essential to balance your cholesterol levels. Apart from diet, it includes:

  • avoid a sedentary lifestyle
  • avoid smoking and alcohol
  • manage your weight
  • reduce your waist circumference.
What are the symptoms of high cholesterol?
Usually, there are no obvious signs or symptoms that indicate you have abnormal levels of cholesterol (that’s why it is called “the silent killer”), the first sign could also be the manifestation of the cardiovascular disease itself:

  • Angina
  • Heart attack
  • Stroke
  • Intermittent claudication – pain on walking

 

 

Do I really need medication for my high cholesterol?
If a healthy lifestyle doesn’t influence your cholesterol levels, your doctor might start you on some cholesterol lowering medication like statins, ezetimibe or fibrates. But medication doesn’t stop you from keeping a healthy lifestyle.

Could I inherit high cholesterol from my parents? It is treatable?
There are over 100 genes that influence how the body manages cholesterol, including high cholesterol. The most common inherited conditions are Familial Hypercholesterolaemia (FH), Familial Combined Hyperlipidaemia (FCH) and Polygenic High Cholesterol.

However, the treatment is the same: first line, changing lifestyle, and if this doesn’t work, medications.

Medication

Statins

Statins are the first type of medication doctors usually prescribe to lower LDL and triglycerides. Studies found that they reduce cardiovascular disease and events alone and are used both in primary and secondary prevention.

Among side effects, muscle pain, intestinal problems and high blood sugar are the most common.

Ezetimibe

This type of drug is recommended as second line of therapy, after an unsuccessful trial of statins. The main mechanism of action is decreasing absorption of cholesterol in the small intestine. Ezetimibe combination drugs are also marketed for better tolerance. Contraindications include previous allergic reactions and severe liver disease, especially in statin combination.

Fibrates

Fibrates are used for a number of metabolic disorders, mainly hypercholesterolaemia and their primary target is triglycerides and consequently boosting the HDL levels. Examples include Fenofibrate and Gemfibrozil. Like Ezetimibe, they can be used alone or in combination with statins.

Safe, real prescriptions for Cholesterol.

Blood Tests

Cholesterol test

This is a simple test of measuring the levels of cholesterol in the blood using either a venous sample or a capillary (pinprick) test – where only a small drop of blood from your finger is used and then inserted in a calibrated device using a strip or cassette. The result from the capillary test can be ready within minutes.

Full lipid profile

The lipid profile or lipid panel is a complete cholesterol test used to measure the “good” cholesterol, the “bad” cholesterol and triglycerides in your blood. It can be performed by any healthcare professional and they usually take a venous sample from your arm, then send it to the laboratory and waiting about 48 hours for the results. For best results, you must not eat at least 8 hours prior to the test.

QRISK score

This prediction algorithm for cardiovascular disease uses data like age, blood pressure, smoking status, lipid panel, BMI and other traditional risk factors. It can be found online at qrisk.org and it is updated annually because of changes in population characteristics, improvements in data quality and changes in requirements for how the risk prediction scores can be used, for example changes in age ranges.

A QRISK score over 10 – that means a 10% risk of a cardiovascular event to occur in the next 10 years – indicates that a lipid lowering therapy should be considered.

Contact me now for advice, prescriptions, blood tests and referrals.

Please note that this service does not aim to replace advice given to you by your own doctor, it is meant to supplement your health knowledge and awareness.

It is never to be used in the case of a medical emergency.

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